title: Caring for individuals with dementia and cognitive impairment, not dementia: findings from the aging, demographics, and memory study.
abstract: OBJECTIVE
  To compare the characteristics and outcomes of caregivers of adults with dementia with those of caregivers of adults with cognitive impairment, not dementia (CIND).
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  In-home assessment for cognitive impairment and self-administered caregiving questionnaire.
  
  
  METHODS
  One hundred sixty-nine primary family caregivers of participants in the Aging, Demographics, and Memory Study (ADAMS). ADAMS participants were aged 71 and older drawn from the nationally representative Health and Retirement Study.
  
  
  METHODS
  Neuropsychological testing, neurological examination, clinical assessment, and medical history were used to assign a diagnosis of normal cognition, CIND, or dementia. Caregiving measures included caregiving time, functional limitations, depressive symptoms, physical and emotional strain, caregiving rewards, caregiver health, and demographic characteristics.
  
  
  RESULTS
  Dementia caregivers spent approximately 9 hours per day providing care, compared with 4 hours per day for CIND caregivers (P=.001). Forty-four percent of dementia caregivers exhibited depressive symptoms, compared with 26.5% of CIND caregivers (P=.03). Physical and emotional strains were similar in both groups of caregivers. Regardless of the strains, nearly all caregivers reported some benefits from providing care. Behavioral problems (P=.01) and difficulty with instrumental activities of daily living (P=.01) in persons with CIND partially explained emotional strain experienced by CIND caregivers. For those with dementia, behavioral problems predicted caregiver emotional strain (P<.001) and depressive symptoms (P=.01).
  
  
  CONCLUSIONS
  Although support services are available to dementia caregivers, CIND caregivers also expend considerable time and experience strains. The real caregiver burden of cognitive impairment in the U.S. population may therefore be greatly underestimated if people who have reached the diagnostic threshold for dementia are focused on exclusively.
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA. gwenithf@isr.umich.edu
authors.forename: Gwenith G
authors.initials: GG
authors.lastname: Fisher
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Franks
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Plassman
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Brown
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.forename: David
authors.initials: D
authors.lastname: Llewellyn
authors.forename: Mary A M
authors.initials: MA
authors.lastname: Rogers
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Langa
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000451:nursing*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009483:Neuropsychological Tests; D013997:Time Factors; D014481:United States